Diagnosis of APC resistance during pregnancy

Cumming, A. M.; Tait, R. C.; Fildes, S.; Hay, C. R. M.

doi:10.1046/j.1365-2141.1996.t01-2-17698.x

Cited by 5 publications

(2 citation statements)

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“…The concurrent action of multiple factors to increase the frequency of thrombosis is well established. [26][27][28][29][30][31][32][33] The frequency and likelihood of thrombosis in individual patients change with time depending on their overall health. High-risk situations, such as malignancy, pregnancy, surgery and the use of estrogens, increase hypercoagulability in those with either inherited and/or acquired coagulation defects.…”

Section: Precipitating Factors In Patients With Inherited and Acquirementioning

confidence: 99%

Cerebral venous sinus thrombosis and thrombophilia presenting as pseudo-tumour syndrome following mild head injury

Muthukumar

2004

Journal of Clinical Neuroscience

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Section: Precipitating Factors In Patients With Inherited and Acquirementioning

confidence: 99%

Cerebral venous sinus thrombosis and thrombophilia presenting as pseudo-tumour syndrome following mild head injury

Muthukumar

2004

Journal of Clinical Neuroscience

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“…This is particularly important before hormonal medication, either oral contraception (OC) or hormone therapy (HT), in menopausal women (7)(8)(9)(10)(11)(12)(13), and has also to be considered before ovulation induction and assisted reproduction (14)(15)(16)(17). The potential relevance for idiopathic pregnancy loss and placental vascular disease is a much discussed issue (18)(19)(20)(21)(22)(23)(24)(25)(26).…”

mentioning

confidence: 98%

Medical history screening for thrombophilic risk: is this adequate?

Eggert‐Kruse

Ziegler

Horlbeck

et al. 2011

Fertility and Sterility

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Activated protein C resistance in normal pregnancy

Cumming¹,

Tait²

1998

BJOG

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C 0 R R E S P 0 N D E N C E 1 129 AUTHORS' REPLY Sir,We thank Drs Bernardes and Costa-Pereira for their continued interest in our article and would like to make the following response to the issues raised in their letter.1. They expressed some concern over the methodology we used.All possible combinations of all baseline differences between the experts (n = 3664, after excluding missing data) were calculated and compared with that between the computer and experts. The minimum and maximum differences between experts was -60 to +60 bpm, with the mean difference being -0.26 bpm and a standard deviation of 6.22 bpm. The 95% confidence interval of these differences was not computed from the standard deviation. It was instead estimated by determining the 2 S h and 97Sth percentile values using the standard frequency distribution function available in SPSS. 2. We concur that our algorithm is not foolproof and not always able to determine a baseline value. We anticipate that even clinicians would have difficulty defining a baseline value in heart rate pattern D or a second stage trace without any preceding trace in pattern A or B antenatally and some presecond stage tracings respectively. The computer has the advantage of being consistent in its interpretation and it is not expected that any interpretation, human or machine, should be able to determine a baseline value under all circumstances. 3. Our approach differs from others working in this area, in that we have deliberately processed only the heart rate information to obtain its variations, before integrating this with physiological and clinical information to produce an overall pathophysiological diagnosis. Only by doing this do we feel that it will be possible to distinguish between how the heart rate varies and what these variations mean. Activated protein C resistance in normal pregnancy Sir,We read with interest the report of Michael Peek et al. concerning activated protein C (APC) resistance in normal pregnancy (Vol 104, September 1997)'. Unlike previous reports2" this study revealed only small changes in APC sensitivity ratios during pregnancy, and no cases of acquired APC resistance. The reason for this discrepancy is not clear. We are not aware of any changes to the standard Chromogenix Coatest APC Resistance kit which may account for this. Peek and colleagues suggest that the standard APC ratio could be used during pregnancy to screen for the factor V Leiden mutation, a suggestion with which our findings lead us to take issues. Using the standard Chromogenix kit to determine APC sensitivity ratios, we observed the development of acquired APC resistance in 11 of 20 healthy women during the course of their pregnancies*. Only one of the 20 women was a carrier of the Factor V Leiden mutation. This led us to suggest that pre-existing APC resistance could not be reliably diagnosed during pregnancy using A m -b a s e d functional assays. Subsequently we showed that a modification of the standard assay, in which the test plasma is diluted with an excess of facto...

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Diagnosis of APC resistance during pregnancy

Cited by 5 publications

References 0 publications

Cerebral venous sinus thrombosis and thrombophilia presenting as pseudo-tumour syndrome following mild head injury

Cerebral venous sinus thrombosis and thrombophilia presenting as pseudo-tumour syndrome following mild head injury

Medical history screening for thrombophilic risk: is this adequate?

Activated protein C resistance in normal pregnancy

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